RAVI HARI PHULWARE
@aiimsrishikesh.edu.in
Assistant Professor, Pathology & Laboratory Medicine/ravipaarti@gmail.com
Ravi Hari Phulware/All India Institute of Medical Sciences Rishikesh
Consultant Histopathologist
Cytopathologist
Onco-pathologists
More than 10 years of experience in the field of Pathology
More than 50 PubMed publication in various International and National Journals
EDUCATION
MBBS
MD Pathology
PGDM Executive (NIHFW) Hospital Management
RESEARCH, TEACHING, or OTHER INTERESTS
Pathology and Forensic Medicine, Histology, Oncology, Nephrology
FUTURE PROJECTS
Molecular landscape of Hereditary cancer gene panel in urinary bladder cancer in young adults of Sub Himalayan region of Uttarakhand and Western Uttar Pradesh
There is limited information on an exome scale about the germline molecular alteration leading to urinary bladder cancer in young patients in India. Patients from Uttarakhand and Western Uttar Pradesh are usually from low socioeconomic strata and come with advanced stages of tumor. Hence there is a felt need of doing exome profiling study to pick up the gene mutations in this region. This will add to the understanding of the pathogenesis of disease and will help in making a gene panel for early screening and detection.
Applications Invited
Scopus Publications
Scopus Publications
Erna Ahsan, Ravi H Phulware, Gayathri Saravanan, B Bhartendu, and Arvind Kumar
SAGE Publications
Cavernous haemangioma of the liver is a common benign vascular lesion, frequently asymptomatic and identified incidentally through imaging techniques. However, its identification during autopsy is uncommon. This report describes a 33-year-old male diagnosed with an incidental cavernous haemangioma of the liver identified during a post-mortem examination. The patient exhibited no previous history of liver disease or symptoms indicative of hepatic pathology. The gross examination identified an ill-defined, dark red, spongy lesion in the hepatic parenchyma. Histopathological analysis confirmed the diagnosis, revealing dilated vascular channels lined by endothelial cells, with no indications of malignancy. The clinical significance of hepatic haemangiomas is associated with potential complications, including rupture, haemorrhage and Kasabach-Merritt syndrome, even though most cases remain asymptomatic. This case emphasises the significance of identifying incidental hepatic haemangiomas in post-mortem examinations and recognising their benign characteristics to prevent unnecessary interventions during life.
Saurabh Kumar Gautam, Ravi Hari Phulware, Erna Ahsan, Amit Gupta, and Prashant Durgapal
Springer Science and Business Media LLC
Ravi H Phulware, Akash Dhiman, Yashpal Sindhu, Ravi P Meshram, Salu Chandran, and Arvind Kumar
SAGE Publications
Rabies, a lethal zoonotic viral disease, continues to pose a significant public health threat worldwide. Caused by lyssaviruses, primarily transmitted through the bite of infected animals, rabies manifests as an acute encephalitis with a nearly universal fatality rate once clinical symptoms appear. The hallmark of rabies infection is its unique neurotropism, targeting the central nervous system and inducing characteristic neurological signs and symptoms. Early diagnosis and prompt administration of post-exposure prophylaxis remain crucial for preventing disease progression and mitigating the risk of transmission. Despite the availability of effective vaccines and immunoglobulins, rabies remains endemic in many regions, particularly in low-resource settings where access to healthcare services is limited. This case provides a comprehensive overview of rabies epidemiology, pathogenesis, clinical manifestations, diagnostic modalities, and current prevention and control strategies. Additionally, it highlights the ongoing challenges in rabies elimination and the importance of interdisciplinary approaches to combat this deadly disease.
Pakesh Baishya, Ravi Hari Phulware, Ashok Singh, Prashant Durgapal, Ankur Mittal, Sanjeev Kishore, and Arvind Kumar
Springer Science and Business Media LLC
Omkar Apte, Bharat Bhartendu, Vikas Kumar Panwar, Tripti Prajapati, and Ravi Hari Phulware
Wiley
ABSTRACTEchinococcosis is one of the zoonotic illnesses. Echinococcus granulosus larvae are the causative agents. Renal hydatid cysts are extremely rare and are typically unilateral. If they evolve slowly, they may not show any symptoms for years. Only 2%–3% of cases of hydatidosis have isolated renal hydatid cysts, making them rare. In this case, the radiological and clinical results suggested only a simple renal cyst, and cytopathology clinched the final diagnosis. A 20 mL turbid cyst fluid sample was sent for cytological analysis. Many scolices with radially arranged hooklets, scattered hooklets, macrophages, foreign body giant cells, and necro‐inflammatory cell infiltrate were visible under the microscope.Inside This Month's CytopathologyIn this study, the author highlights the cytology features of renal hydatidosis clinically and radiologically, mimicking a simple renal cyst. This case demonstrates the relevance of cytopathological screening in the early detection of unusual illnesses at rare locations.Tweeting (~280 Characters) Through Cytopathology Twitter HandleA study of 24 #renal lesions found #FNA #fluid cytology on laparoscopic deroofing of the left renal cyst. Smears show singly scattered hooklets, intact scolices with radially arranged hooklets in a background of acellular debris and foreign body giant cells. #CytoJ #CytoPath #hydatid cyst #renal cyst #cytology.
Kavita Khoiwal, Shalini Bose, Ravi Hari Phulware, Manisha Perka, and Jaya Chaturvedi
Galenos Yayinevi
Arushi Verma, Vikas Vaibhav, Raviprakash Meshram, Ashish Bhute, Dilip Vaishnav, and Ravi H. Phulware
SAGE Publications
Autopsy surgeons routinely encounter cases involving alleged use of poison. Many of these cases are due to poisonous plant species that grow wildly in different regions of the world and are readily accessible to the general population. Thevetia peruviana (syn. Cascabela thevetia ) is a cardiotoxic evergreen shrub that is native to Latin America and has been introduced horticulturally to other global tropical and subtropical regions with subsequent establishment among the native flora. The cardiac glycosides found in the plant have digoxin-like effects. A 50-y-old male with an alleged history of accidental ingestion of T peruviana was brought for autopsy to the mortuary at the Department of Forensic Medicine and Toxicology. This case report highlights the postmortem findings in a case of T peruviana poisoning. It provides valuable insights for autopsy surgeons, ensuring their preparedness when confronted with similar cases.
Arvind Kumar, Amit Gupta, and Ravi Hari Phulware
Springer Science and Business Media LLC
Monika Maharjan, Zahed Ali Qamer, Bheru Dan Charan, Manu Malhotra, and Ravi Hari Phulware
Springer Science and Business Media LLC
Gajendra Kumar Yadav, Ravi H. Phulware, Ashok Singh, Arvind Kumar, Prashant Durgapal, Nilotpal Chowdhury, Shalinee Rao, Shalini Rajaram, Sanjeev Kishore, and Rajlaxmi Mundhara
S. Karger AG
Introduction: Intraoperative cytology in ovarian tumors involves collecting cell samples from the ovarian sample sent during surgery and quickly examining them for diagnostic information. Frozen section provides rapid diagnosis to guide intraoperative patient management. The indications of frozen section are identification of tissue, evaluation of margins and identification of lymph nodes metastasis. Aim: To evaluate comparative diagnostic utility of squash smear, scrape smear and imprint cytology with frozen section in intraoperative ovarian tumour. Materials and methods: Intraoperative tissue from clinico-radiologically suspected ovarian. tumour for frozen section taken and processed in Department of Pathology and Laboratory Medicine. Squash smear, scrape smear and imprint smear were made. Three stains (Rapid MGG, Rapid Pap and Rapid H & E) with expected TAT of <15 minutes were done. Intraoperative cytological smear (squash, scrape and imprint smear) were correlated with frozen section & Histopathology slide. Final assessment of intraoperative cytological smears for diagnostic accuracy was done using statistical study. Results: Sensitivity, Specificity, and Diagnostic accuracy for frozen and cytology were: Sensitivity of frozen section, squash cytology and scrape cytology was 91.67% in all three, whereas sensitivity of imprint was 87.5%. Specificity of frozen section, imprint cytology, squash cytology and scrape cytology was 96.77%, 93.55%, 90.32% and 90.32% respectively and accuracy was 94.55%, 90.91%, 90.91% and 90.91% respectively. Conclusion: Imprint, squash, and scrape cytology has similar sensitivity and specificity compared to frozen section in identifying the nature of lesion and can be an alternative to frozen section in resource stricken setting.
Samikshya Thapa, Akanksha Gupta, Vikas Kumar Panwar, and Ravi Hari Phulware
BMJ
Smooth muscle cells in the renal parenchyma or renal pelvis give rise to the incredibly uncommon and aggressive kidney cancer known as leiomyosarcoma. Because it is uncommon and has nonspecific clinical features, it can be challenging to diagnose, making up less than 1% of all kidney tumours. Adults frequently exhibit it, with a slight preference for females in some instances that have been reported. A male in his early 60s with a history of abdominal pain for the previous 2 months is presented here with a case of leiomyosarcoma of the kidney. While adjuvant medications like chemotherapy and radiation therapy have little effect, surgical resection with clear margins remains the main treatment option. There is a considerable chance of recurrence, so long-term monitoring is necessary.
Erna Ahsan, Saurabh Kumar Gautam, Ashok Singh, Arvind Kumar, and Ravi Hari Phulware
Scientific Scholar
The mainstay of treatment for ovarian cancer is surgery. To prevent under-treatment and overtreatment and to choose the best surgical strategy for patients with ovarian tumors, intraoperative pathological assessment is essential. Frozen sections (FSs) have been historically used for intraoperative evaluation. In 1927, cytology was introduced by Dudgeon and Patrick as a new method of intraoperative pathological examination. Diagnosis can be made in minutes by making smears from the lesion, staining them quickly, and analyzing them under a microscope. Following a comprehensive search of the literature, using pertinent keywords in PubMed, and reviewing the data, it was discovered that intraoperative cytology (IOC) had been reported to have a diagnostic accuracy in ovarian lesions comparable to that of FSs. Few of the studies have confirmed that IOC has several benefits over FSs. There are drawbacks as well, which one should be mindful of. In this review, every aspect that is connected to IOC is covered in detail, along with the potential for raising the standard of IOC to make it more applicable in the present times.
Ravi Hari Phulware and Naveen Kumar Kansal
Ovid Technologies (Wolters Kluwer Health)
Kartik Saini, Naveen Kumar Kansal, Ravi Hari Phulware, and Riti Bhatia
BMJ
Paediatric Systemic lupus erythematosus (SLE) constitutes 10 to 20% of cases of SLE with more severe disease and higher mortality. We report a case of an adolescent girl with SLE with multisystem involvement who was started on hydroxychloroquine and oral prednisolone. However, due to persistent worsening of skin lesions and falling cell counts, pulsed dexamethasone was initiated which showed improvement in the skin lesions, cell counts, proteinuria and pleural effusion but there was a persistent fall in the haemoglobin. The patient was diagnosed with refractory autoimmune hemolytic anemia (AIHA) and treated with Rituximab which showed marked improvement in AIHA. Therefore, Rituximab can be considered in managing childhood SLE with refractory AIHA.
Anshima Singh, Ravi Hari Phulware, Arvind Kumar, Alok Kumar, and Sanjeev Kishore
Ovid Technologies (Wolters Kluwer Health)
Anusha Mruthyunjaya Swamy, Deepak Sundriyal, Mayank Kapoor, Mridul Khanna, Ravi Hari Phulware, Kranthi Kumar Jandrasupalli, Ujjawal Shriwastav, and Amit Sehrawat
Wiley
ABSTRACTIntroductionWith the use of immune checkpoint inhibitors (ICIs) and targeted therapies, the clinical outcomes of metastatic melanoma have drastically improved. The current scenario has reduced the use of chemotherapy as a first‐line treatment. We report an interesting case of a patient with stage IV ano‐rectal canal malignant melanoma with an exceptional response to single‐agent temozolomide.Case ReportWe diagnosed a 55‐year‐old female with stage IV anorectal melanoma, BRAF V600 mutation negative. Owing to her poor performance status (PS) and non‐affordability of immunotherapy, after informed decision‐making, she was started on single agent, temozolomide. She achieved a complete metabolic response and sustained it for 3 years and continues to do so with the first‐line single‐agent temozolomide.ConclusionIn a resource‐limited setting, where access to ICIs and targeted therapies is not feasible, and in patients who fail to tolerate these therapies, oral chemotherapy continues to remain effective and is worth trying in patients with poor PS.
Palak Nandolia, Khanak Nandolia, Ravi Hari Phulware, and Sonal Saran
Springer Science and Business Media LLC
Palak Nandolia, Khanak Nandolia, Ravi Hari Phulware, and Sonal Saran
Springer Science and Business Media LLC
Shalini Rajaram, Ayush Heda, Latika Chawla, and Ravi Hari Phulware
Springer Science and Business Media LLC
Samikshya Thapa, Gajendra Kumar Yadav, Ramit Kumar Shah, Arvind Kumar, and Ravi Hari Phulware
Springer Science and Business Media LLC
Pragya Singh, Lekshmi R, Sweety Gupta, Ravi Roushan Kumar, Shreyosi Mandal, Mridul Khanna, Satya Sree Balija, Ravi Hari Phulware, and Manoj Gupta
Elsevier BV
Shalini Rajaram, Lakhwinder Singh, Ayush Heda, Latika Chawla, Ravi Hari Phulware, Ashok Singh, and Simardeep Kaur
Elsevier BV
Sonali Mishra, Ravi Hari Phulware, Akash Dhiman, Bibek Keshari, Ashok Singh, and Arvind Kumar
Springer Science and Business Media LLC
Nishi Jha, Ravi Hari Phulware, Arvind Kumar, Ashok Singh, Prashant Durgapal, Nilotpal Chowdhury, Ankur Mittal, and Sanjeev Kishore
Springer Science and Business Media LLC
Palak Nandolia, Khanak Kumar Nandolia, Ravi Hari Phulware, and Sonal Saran
BMJ